Individual provider Active NPI

Jamie Kathryn Rendler, FNP-C WOCN-AP CLT

  • Family Nurse Practitioner
  • Pueblo, CO
National Provider Identifier
1861808750
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN.0991270-NP Issued in CO
Practice address
401 Michigan St
Pueblo, CO 81004-2138
Phone
(719) 766-9360
Fax
(719) 888-1893
NPI assigned
Jul 11, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Continence Care Registered Nurse 163WC2100X RN.0182338 CO
Wound Care Registered Nurse 163WW0000X RN.0182338 CO
Ostomy Care Registered Nurse 163WX1500X RN.0182338 CO
Family Nurse Practitioner 363LF0000X APN.0991270-NP CO Primary

Addresses

Primary practice location

401 Michigan St
Pueblo, CO 81004-2138

Mailing address

401 Michigan St
Pueblo, CO 81004-2138
Phone (719) 766-9360

Other names 1

  • Jamie Kathryn Peterson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230726001662 CO Practitioner - Nurse Practitioner 8628345782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beewell Clinic IncGroup PAC ID 6002341823, 2 clinicians

Practice addresses (Care Compare)

401 Michigan St
Pueblo, CO 81004-2138
Phone (719) 766-9360

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN.0182338COMDWound Care Registered Nurse
APN.0991270-NPCOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Beewell Clinic Inc CurrentSince Mar 15, 2025 Accepting new patients

Locations

401 Michigan St
Pueblo, CO 81004
Phone (719) 545-3555

Interoperability endpoints

  • FHIR API: https://drchrono-fhirpresentation.everhealthsoftware.com/fhir/drchrono/507425/r4

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1861808750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 MICHIGAN ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042138",
            "telephone_number": "719-766-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MICHIGAN ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042138",
            "telephone_number": "719-766-9360",
            "fax_number": "719-888-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENDLER",
        "first_name": "JAMIE",
        "middle_name": "KATHRYN",
        "credential": "FNP-C WOCN-AP CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-11",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC2100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continence Care",
            "state": "CO",
            "license": "RN.0182338",
            "primary": false
        },
        {
            "code": "163WW0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Wound Care",
            "state": "CO",
            "license": "RN.0182338",
            "primary": false
        },
        {
            "code": "163WX1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ostomy Care",
            "state": "CO",
            "license": "RN.0182338",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0991270-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "PETERSON",
            "middle_name": "KATHRYN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.